How is Waldenstrom macroglobulinemia/lymphoplasmacytic lymphoma diagnosed?

Updated: Jan 04, 2018
  • Author: Joseph M Tuscano, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Recommended diagnostic studies to evaluate a suspected diagnosis of Waldenstrom macroglobulinemia/lymphoplasmacytic lymphoma are as follows [1] :

  • History and physical examination with complete neurologic and ophthalmologic examination

  • Quantitative serum immunoglobulin G, immunoglobulin A, and immunoglobulin M (IgM) (total levels of serum immunoglobulins should be assessed with nephelometry)

  • Serum immunofixation

  • Twenty-four–hour urine collection for protein electrophoresis

  • Serum free light-chain assay

  • Bone marrow biopsy with cytogenetics, fluorescence in situ hybridization (FISH) (for lymphoma and myeloma), and flow cytometry (should include CD19, CD20, CD38, and CD138)

  • CT scanning of the chest, abdomen, and pelvis (to assess for lymphadenopathy and splenomegaly)

  • Complete blood cell (CBC) count and serum chemistries

  • Serum viscosity

  • Autoantibodies, Coombs test, cold agglutinins, cryoglobulins, anti–myelin-associated glycoprotein (MAG) antibodies (based on history and physical finding)

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